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General NPI Number Information
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NPI Number | 1982944609
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Entity Type | Individual
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Provider Name | DEBRA MARIE SANDGREN LMFT
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Gender | Female
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Dates
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Enumeration Date | 02/15/2013
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Last Update Date | 03/20/2017
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Provider Practice Location Address
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Address Line | 135 E 3RD AVE STE B
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City | ESCONDIDO
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State | CA
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Zip | 92025-4252
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Country | US
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Telephone | 619-786-5835
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Fax |
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Provider Business Mailing Address
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Address Line | 30271 SILVER RIDGE CT
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City | TEMECULA
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State | CA
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Zip | 92591-7315
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Country | US
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Telephone | 619-786-5835
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 48637
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License Number State | CA
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